Ghost - blastocyst transfer

[jb728]

Hi Ghost,
My clinic has a new policy in which they only transfer day 6 blastocysts. Embryos that are not at that stage by day 6 are frozen. I am trying to decide whether to transfer 1 or 2 embryos (if we make it that far).

My first cycle, none of my 6 embryos made it to transfer.
My second cycle, I transferred 2 embryos (1 was my son and the other did not implant), and two did not make it to freeze.
For these two cycles, my clinic did not have the day 6 transfer policy, and my transfer for the above cycle was on day 5.
This cycle, I have 3 embryos that will hopefully make it to transfer.

My question is, does it make a difference in success rate/implantation if embryos are transferred at the blastocyst stage (versus a morula or 3 day transfer)? I fear with my history of embryos not making it, if I only transfer one, the others won't survive a freeze/thaw. However, ideally we are hoping for a singleton pregnancy.

Any input you could give me would be appreciated! Thank you in advance for your time.

[Ghost]

Hi Ghost,
My clinic has a new policy in which they only transfer day 6 blastocysts. Embryos that are not at that stage by day 6 are frozen. I am trying to decide whether to transfer 1 or 2 embryos (if we make it that far).

My first cycle, none of my 6 embryos made it to transfer.
My second cycle, I transferred 2 embryos (1 was my son and the other did not implant), and two did not make it to freeze.
For these two cycles, my clinic did not have the day 6 transfer policy, and my transfer for the above cycle was on day 5.
This cycle, I have 3 embryos that will hopefully make it to transfer.

My question is, does it make a difference in success rate/implantation if embryos are transferred at the blastocyst stage (versus a morula or 3 day transfer)? I fear with my history of embryos not making it, if I only transfer one, the others won't survive a freeze/thaw. However, ideally we are hoping for a singleton pregnancy.

Any input you could give me would be appreciated! Thank you in advance for your time.

Two main views on this.

Some use blastocyst culture to screen out the worst embryos so the best can be selected for transfer. Under that model, a patient with just one or two viable day 3 embryos might as well transfer on day 3. They already know which are the best for transfer.

Others use blastocyst culture to screen out embryos that cannot reach the blastocyst stage. They figure it's worse to transfer a bad embryo than to not transfer it, even if it's the only remaining embryo. These clinics tend to do more blastocyst transfers than the others do, and some do 100% blastocyst transfer.

The success rates per transfer are higher with blastocyst transfer, when the same number of embryos are transferred. Whether the success rates are greater per retrieval is more complicated.

An advantage of blastocyst transfer is the transfer of fewer embryos, ideally just one, because of the greater implantation rates. This is supposed to reduce the risk of multiple pregnancy.

[woodyanita]

Blastocyst transfer is not suitable for everyone. It is a laboratory selection process to identify the best embryo. Couples who have had unsuccessful prior attempts with IVF or IVF and ICSI treatment despite having many good quality eggs retrieved are being offered Blastocyst Culture as an alternative treatment. Couples with multiple good quality embryos on day 3 are also good candidates for Blastocyst Culture. The ability to select the most viable embryos for transfer and implantation should improve their chance of achieving a pregnancy. Hence if your clinic is of the opinion to transfer the embryos on day 6 then you should go with them and get it transferred on day 6. If you need any clarification or guidance you can contact the clinic Rotunda The Centre for Human Reproduction based in Mumbai. They can be contacted at http://www.iwannagetpregnant.com/blasto ... sfer.shtml